Pelvis Flashcards
1
Q
the pelvic organs are _____peritoneal
A
infra peritoneal
2
Q
why might the bladder be enlarged in older males
A
enlargement of the prostate can lead to problems emptying the bladder so it distends
3
Q
which bone the bladder found in very close contact with
A
pubic bone
4
Q
which surface of the bladder is covered in peritoneum
A
superior/posterior surface
5
Q
what are the pouches formed by the peritoneum covering the pelvic organs
A
females
rectouterine pouch
vesicouterine pouch
males
rectovesical pouch
6
Q
what is the urachus
A
embryological remnant
7
Q
what type of epithelium lines the bladder
A
transitional epithelium
8
Q
what is the name of the folds in the bladder lining
A
rugae
9
Q
which structure can be seen surrounding the urethra in males and is assoicated with the underside of the bladder
A
prostate
10
Q
what is the trigone
A
triangular base of the bladder
11
Q
which region does the bladder enter when it fills with urine
A
suprapubic region
12
Q
describe the internal surface of the trigone
A
area of smooth mucous membrane
13
Q
which three openings make up the corners of the trigone
A
ureters entering the bladder
urethra leaving the bladder
14
Q
describe the openings of the ureters into the bladder
why are they like this
A
small slit like openings that close over themselves
to prevent black flow of urine up the ureter to the kidney
15
Q
what is the name of the muscle that makes up the bladder wall
A
detrusor muscle
16
Q
what type of muscle is the detrusor muscle
A
smooth muscle
17
Q
what is the name of the sphincter at the neck of the bladder
A
sphincter vesicae
18
Q
what is the name of the urethral sphincter located in the urogenital triangle
A
sphincter urethrae
19
Q
what is the difference between sphincter vesicae and sphincter urethrae
A
vesicae = smooth muscle (involuntary) urethrae = skeletal muscle (voluntary)
20
Q
which ligaments old the neck of the bladder in place
A
puboprostatic (MALE)
pubovesical (FEMALE)
21
Q
arterial supply to the bladder
A
2x superior vesical arteries
1x inferior vesical arteries
22
Q
which arteries are the vesicle arteries branches of
A
internal iliac
23
Q
what is the inferior vesical artery often known as in females
A
vaginal artery
24
Q
where do the inferior vesical/vaginal arteries supply
A
inferior surface of bladder
25
venous drainage of the bladder
vesical plexus to internal iliac vein
26
autonomic innervation of bladder
inferior hypogastric plexus
27
lymph drainage of ureter
lumbar, common iliac and external iliac nodes
| changes as the ureter descends towards the bladder
28
lymph drainage of bladder
main drainage to internal iliac nodes
superior to external iliac nodes
neck area to sacral nodes
29
lymph drainage of urethra
mainly to internal iliac nodes
male spongy urethra to deep inguinal
females to sacral nodes
30
describe how the rectum is covered in peritoneum as it descends
upper 1/3 covered by visceral peritoneum
middle 1/3 covered on anterior surface
lower 1/3 infra peritoneal
31
where does the rectum run from
approximately 3rd sacral vertebra to tip of coccyx
32
when does the rectum become the anal canal
as it passes through the pelvic floor
33
which structure creates folds in the internal surface of the rectum and what are the sacculations called
transverse folds creates ampulla
34
which structures in the rectum aid in faecal continence
voluntary sphincter in the anal triangle
involuntary sphincter the the walls of the the rectum
puborectalis muscle loops around rectum
35
how does puborectalis aid in maintenance of faecal continence
creates a sling around the rectum
| creates a bend in the rectum so when the muscle relaxes the bend lessens the angle allowing passage through the rectum
36
arterial supply to the rectum
superior rectal artery = inferior mesenteric artery
middle rectal artery = internal iliac artery
inferior ectal artery = internal pudendal artery
37
venous drainage of the rectum
```
superior = portal system
middle = internal iliac
inferior = internal pudendal
```
38
lymph drainage of rectum
pararectal nodes to inferior mesenteric and internal iliac nodes
allows spread of disease in two directions
39
nerve supply to rectum
inferior hypogastric plexus
40
how can the uterus be identified in the pelvis
midline structure between the bladder and rectum that appears to communicate with both sides of the body wall laterally
41
what is the broad ligament made up of
double layer of peritoneum
42
what are the areas of the broad ligament
```
mesosalpinx = over Fallopian tube
mesovarium = over ovaries
mesometrium = over uterus
```
43
what structures are contained in the broad ligament
veins and arteries
44
whats supplied by the ovarian artery
top part of uterus, fungus, Fallopian tube and ovaries
45
what does the uterine artery supply
lower uterus
46
what does water under the bridge mean
uterine artery passes over the ureter
47
what are fimbriae
little fingers at the end of the fallopian tube
48
what are the main parts of the uterine tube
fimbriae
infundibulum
ampulla
isthmus
49
what does the round ligament provide
a potential pathway for lymph to the abdominal cavity
50
where does the majority of the support of the uterus come from
ligaments attaching to the cervix
| NOT THE BROAD LIGAMENT
51
what ligaments provide support to the cervix
uterosacral (sacrocervical)
transverse cervical
pubocervical (pubovesical)
52
what position is the uterus normally in
anteverted and ante flexed
53
what does anterverted mean (related to uterus)
long axis of the uterus is bent forward on long axis of vagina
54
what does ante flexed mean (related to uterus)
long axis of uterus is bent forward at internal os with long axis of vagina
55
blood supply to the ovaries
gonadal arteries
| arise from abdominal aorta L2
56
venous drainage of ovaries
left to left renal vein
| right to IVC
57
nerve supply to ovaries
aortic plexus
58
what structures are found in the suspensory ligaments of ovaries
ovarian vessels
59
what does the vas deferens join with to form the ejaculatory duct
ducts from the seminal vesicles
60
where are the seminal vesicles located
superior to prostate
61
what do the seminal vesicles secrete
liquid component of seen
| including fructose
62
where is the prostate located
inferior to bladder
63
what does the prostate secrete
proteolytic enzymes and acid phosphatase
64
which arteries supply the prostate
internal pudendal
middle rectal
inferior vesical
65
describe the venous drainage of the prostate
deep dorsal vein of penis
venous plexus
internal iliac vein
66
what ligament supports the prostate
Puboprostatic ligament
| anterosuperior surface of prostate to internal surface of pubic bone
67
which muscle supports the prostate
| and where does it arise from
levatore prostatae
| anterior fibres of Levator ani
68
how does levatore prostatae support the prostate
fibres from each side descend the sides of the prostate and join together to form a sling of muscle
69
lymph drainage of testes
aortic nodes at root of testicular artery (L2)
70
lymph drainage of skin of penis and wall of scrotum
superficial inguinal nodes
71
borders of the anal triangle
between the ischial tuberosities and coccyx
72
where is the centre point of the perineum
midpoint between ischial tuberosities
73
what structure is located in the anal triangle
anal canal
74
what are the boundaries of the ischioanal fossa
walls: ischial tuberosity and rectum/anal canal
roof: levator ani
floor: skin
75
what are the contents of the ischioanal fossa
branches of the pudendal nerve, artery and vein
| adipose tissue
76
when does the rectum become the anal canal
when it pierces the pelvic floor
77
where is the internal anal sphincter found
within the walls of the rectum as it passes through the pelvic floor
78
where is the external anal sphincter found
surrounding the anal canal inferior to the internal anal sphincter
79
what structures are associated with the anal columns
terminal radicles of the superior rectal vessels
| anal sinus
80
which structures supports the external anal sphincter
perineal body anteriorly
| anococcygeal ligament posteriorly
81
innervation of external anal sphincter
pudendal nerve (S2-4_ inferior rectal branch
82
what are the 3 parts of the external anal sphincter
deep
superficial
subcutaneous
83
what is the pectinate line
site of the anal membrane in foetus
84
where is the pectinate line
at level of deep part of external anal sphincter
85
what is the anocutaneous line
aka white line
| transition to true skin
86
what is the relevance of pectinate line with respect to neuromuscular supply
separates visceral and parietal supply
87
describe neurovascular supply to the anal canal/rectum above the Pectineal line
VISCERAL
nerve: visceral motor (para/sypmathetic) and sensory
artery: from inferior mesenteric
vein: to portal system
lymph: to internal iliac nodes
88
describe the neuorvascular supply to the anal canal/rectum below the pectinate line
PARIETAL
nerve: somatic motor and sensory
artery: from internal iliac
vein: to caval system
lymph: to superficial inguinal
89
boundaries of the urogenital triangle
theoretical lines between the pubic symphysis and the ischial tuberosities
90
fatty fascia in the pelvic region
camper's fascia
91
what is camper's fascia continuous with in the pelvis
ischiorectal fascia
| fascia of thigh
92
what is camper's fascia replaced with in males in the scrotum
dartos muscle
93
what is the membranous fascia in the pelvis called
colles' fascoa
| continuous with Scarpa's fascia of the abdomen
94
where does colles' fascia attach and where does it extend
attaches to the posterior border of the urogenital diaphragm
extends into the labia/scrotum
95
what are the three layers of the urogenital diaphragm
superior layer of fascia
middle layer of muscle
inferior layer of fascia
96
describe the superior layer of fascia in the urogenital diaphragm
deepest layer
| blends with the perineal body and membrane
97
describe the middle layer of the urogenital diaphragm
contains sphincter urethrae and deep transverse perineal muscles
98
sphincter urethrae is innervated by
pudendal nerve S2-4
99
sphincter urethrae is smooth/skeletal
skeletal muscle
100
describe the inferior layer of the urogenital diaphragm
superficial
| aka perineal membrane
101
what is the inferior to the perineal membrane
superficial perineal pouch
102
the urogenital diaphragm is attached to the pubic bone
| true of false
the layers fuse and leave a small gap at the pubic symphysis to allow passage of blood vessels
103
where the deep perineal pouch
between the fascial layers of the urogenital diaphragm
104
what structures are located in the deep perineal pouch
```
urethra
sphincter urethrae
deep transverse perineal muscles
internal pudendal vessels
vagina + dorsal nerves of clitoris
membranous urethra, dorsal nerves of penis, bulbourethral glands and penile arteries
```
105
muscles in the superficial perineal pouch
ischiocavernosus
bulbospongiosus
superficial transverse perineal muscles
106
what structures are found in the superficial perineal pouch
```
muscles
urethra
vagina/clitoris or penis
erectile tissue
nerves and vessels
```
107
describe bulbospongiosus in males
covers the bulb and corpus spongiosum
108
innervation of bulbospongiosus
pudendal nerve
109
describe ischiocavernosus in males
extends from the ischium to corpus cavernosa (x2)
110
innervation of ischiocavernosus
pudendal nerve
111
how do the muscles associated with the erectile tissues aid in their function
contract to compress blood vessels and prevent blood leaving the tissue
112
deep transverse perineal muscles are present in males/females/both
males
113
describe bulbospongiosus in females
wraps around each side of the opening of the vagina (from bulb of vestibule)
114
describe ischiocavernosus in females
extends from ischium to erectile tissue anteriorly (x2)
115
which structures are extensions of the crura
corpus cavernosa
116
what structures does the bulb of the penis contribute to
corpus spongiosus
117
the female equivalent of the bulbourethral glands are located where
in the superficial pouch (superficial to the perineal membrane)
118
which structure runs through the corpus spongiosum
urethra
119
the corpus spongiosum ends in which structure
glans
120
which structures are contained in the corpus cavernosa
deep artery of penis
121
what is the perineal body
small fibrous structure at the posterior margin of the urogenital diaphragm
122
what is the function of the perineal body
muscle attachment
123
which structures attach to the perineal body
external anal sphincter
bulbospongiosus
superficial transverse perineal muscles
124
which penile vessels lie outwith the erectile tissue
dorsal and deep dorsal arteries
125
what are the 4 parts of the male urethra
pre-prostatic
prostatic
membranous
penile/spongy
126
describe the prostatic urethra
widest part
| receives the ejaculatroy duct
127
describe the membranous urethra
narrowest part
| passes through urogenital diaphragm
128
what are the two main muscles of the pelvic floor
levator ani
| coccygeus
129
what are the two parts of levator ani
Pubococcygeus and iliococcygeus
130
origin of Pubococcygeus
posterior surface of pubic bone
131
insertion of Pubococcygeus
anococcygeal ligament
coccyx
perineal body
132
innervation of Pubococcygeus
```
nerve to levator ani (S4)
pudendal nerve (S2-S4)
```
133
origin of iliococcygeus
tendinous arch of levator ani
134
insertion of iliococcygeus
anococcygeal ligament
| coccyx
135
innervation of iliococcygeus
nerve to levator ani (S4)
136
origin of coccygeus
ischial spine
137
insertion of coccygeus
inferior end of sacrum
| coccyx
138
innervation of coccygeus
direct branches from S4-S5
139
which aspect of the pelvic floor does is made up by coccygeus
posterior
140
what are the parts of Pubococcygeus
puboprostaticus/pubovaginalis
| puborectalis
141
describe puboprostaticus/pubovaginalis
muscle fibres pass around the inferior part of the prostate/posterior wall of vagina
142
what is the other name for puboprostaticus
levator prostatae
143
describe puborectalis
muscle fibres pass behind rectum to form a muscular sling around anorectal junction
144
what is the function of puborectalis
contraction increases the angle and helps to maintain faecal continence
145
what is the main innervation of the pelvic floor
pudendal nerve (S2-S4)
nerve to levator ani (S4)
direct branches from S4-S5
146
origin of piriformis
anterior surface of sacrum
147
insertion of piriformis
greater trochanter of femur
148
which vessels can be identified by their position relative to piriformis
superior and inferior gluteal arteries
149
innervation of piriformis
nerve to piriformis (S1-S2)
150
origin of obturator internus
anterior surface of obturator membrane and bony boundaries of obturator foramen
151
insertion of obturator internus
medial surface of greater trochanter
152
innervation of obturator internus
nerve to obturator internus (L5-S1)
153
which foramen foes piriformis pass through to reach the greater trochanter
greater sciatic foramen
154
which foramen does obturator internus pass through to reach the greater trochanter
lesser sciatic foramen
155
what is the function of the thickened fascia over obturator internus
attachment of levator ani
156
were is the bifurcation of aorta
L4
157
branches of the common iliac arteries
external iliac
| internal iliac
158
where do the common iliac divide
at the level of SI joint
159
branches of anterior division of internal iliac
```
umbilical
superior vesical
obturator
middle rectal
inferior gluteal
inferior vesical/uterine
internal pudendal
```
160
branches of posterior division of internal iliac
Iliolumbar
lateral sacral
superior gluteal
161
which artery is a branch of the umbilical artery
superior vesical
162
what is the function of the umbilical artery in utero
transports deoxygenated blood from the foetus to the placenta
163
what does the inferior vesical artery supply in males
inferior bladder
prostate
seminal vesicles
164
how does the uterine artery reach the uterus
in the cardinal ligament
165
which branches are given off the uterine artery
vaginal branches
166
describe the course of the internal pudendal artery
exits pelvis via greater sciatic foramen, wraps around the ischial spine and enters the perineum via the lesser sciatic foramen
167
which nerve accompanies the internal pudendal artery
pudendal nerve
168
what is the terminal branch of the anterior division of internal iliac
inferior gluteal
169
how does inferior gluteal artery leave the pelvis
via greater sciatic foramen
170
branches of the posterior trunk
Iliolumbar
lateral sacral
superior gluteal
171
what is the terminal branch of the posterior division of internal iliac
superior gluteal
